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Pharmacology > Pain/MSK > Flashcards

Pain/MSK Flashcards

1
Q

NSAID

Name

A

Diclofenac

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2
Q

NSAID

Mechanism of action

A

Inhibits prostaglandin synthesis via COX and modulates arachidonic acid release/uptake

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3
Q

NSAID

Indications

A

Pain, RA, osteoarthrosis, LBP, migraines, MSK acute issues, AS, acute gout

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4
Q

NSAID

Contraindications

A

PUD/gastric pain, CHD, organ failure, last trimester

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5
Q

NSAID

Side effects

A

Vertigo, N&V, diarrhoea, dyspepsia, elevated AST, rash, fluid retention

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6
Q

NSAID

Interactions

A

Chemotherapy drugs, methotrexate, renal impairment, warfarin

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7
Q

NSAID

Prescription advice

A

Take with food, consider gastroprotection >60/PUD

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8
Q

Compound Opioids

Name

A

Cocodamol, co-dydramol

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9
Q

Cocodamol

Mechanism of action

A

Activated by CYP450 to morphine, agonises opioid mu-pain receptors

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10
Q

Cocodamol

Indications

A

Mild-moderate pain

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11
Q

Cocodamol

Contraindications

A

Respiratory disease, renal/hepatic impairment

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12
Q

Cocodamol

Side effects

A

Nausea, constipation, drowsiness, toxic (hepatotoxic pcm/neuro-resp from opioid)

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13
Q

Cocodamol

Interactions

A

Avoid with other sedatives (antipsychotic, benzos, TCAs)

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14
Q

Strong Opioids

Name

A

Morphine, Oxycodone

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15
Q

Morphine

Mechanism of Action

A

Activates mu-opioid receptors to relieve pain, reduces response to hypercapnia/hypoxia

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16
Q

Morphine

Indications

A

Acute severe pain, chronic pain, end of life breathlessness

17
Q

Morphine

Contraindications

A

Resp failure, hepatic/renal impairment, biliary colic (sphincter of oddi spasm)/pancreatic issues

18
Q

Morphine

Side effects

A

Resp depression, neuro depression, can activate CTZ, pupillary constriction, increased smooth muscle tone, urticarial

19
Q

Morphine

Interactions

A

Other sedative meds

20
Q

Non-opioid analgesic
Paracetamol
Mechanism of action

A

Weak COX inhibitor reduces fever due to hypothalamic interaction, otherwise poorly understood

21
Q

Paracetamol

Indications

A

First line analgesic, anti-pyrexial

22
Q

Paracetamol

Contraindications

A

Chronic ETOH XS (raised NAPQI), reduced glutathione stores (malnourished, underweight)

23
Q

Paracetamol

Side effects

A

Hepatotoxic

24
Q

Paracetamol

Interactions

A

CYP inducers increase risk of toxicity (phenytoin, carbamazepin)

25
Q

Xanthine oxidase inhibitors
Allopurinol
Mechanism of action

A

Prevent metabolism of xanthine (from purines) to uric acid, lowering plasma concentration and reducing risk of joint precipitation

26
Q

Allopurinol

Indications

A

Prevention of gout, some renal stones, hyperuricaemia, tumour lysis syndrome (chemo)

27
Q

Allopurinol

Contraindications

A

Acute attacks of gout, recurrent rash/hypersensitivity

28
Q

Allopurinol

Side effects

A

Rash, stevens-johnson syndrome, toxic epidermal necrolysis, drug hypersensitivity syndrome

29
Q

Allopurinol

Interactions

A

Drugs that req xanthine oxidase for metabolism (mercaptopurine, azathioprine)

Pharmacology (14 decks)

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